College of Nursing & Health Sciences, Flinders University, Bedford Park, South Australia, Australia.
College of Medicine & Public Health, Flinders University, Bedford Park, South Australia, Australia.
Nurs Health Sci. 2021 Mar;23(1):255-262. doi: 10.1111/nhs.12807. Epub 2021 Feb 2.
Recovery-oriented mental health practice guidelines recommend regular consumer involvement in care plans, yet in many acute settings, these are not routinely created thereby compromising accountability. This study explored the impact of workplace culture on the capacity of mental health nurses to involve consumers in care planning and consequently to work accountably. A focused ethnography was undertaken in one Australian inpatient unit involving mental health nurses and other health professionals. Data were derived from in-depth semistructured interviews with 12 nurses and 6 months of nonparticipant observation of multidisciplinary meetings and clinical handovers. Workplace culture had an impact on mental health nurses' accountability practices. A culture that prioritized reduction in length of stay resulted in less recovery-oriented care. Health professionals who paid more attention to crisis and risk management resulted in fewer opportunities for consumer-involved care planning.
康复导向型心理健康实践指南建议定期让消费者参与护理计划，但在许多急性治疗环境中，这些计划并未常规制定，从而影响了责任的履行。本研究探讨了工作场所文化对精神科护士参与护理计划的能力，以及由此履行责任的能力的影响。在澳大利亚的一个住院病房中进行了一项重点民族志研究，涉及精神科护士和其他卫生专业人员。数据来自对 12 名护士的深入半结构化访谈以及对多学科会议和临床交接的 6 个月非参与式观察。工作场所文化对精神科护士的问责制实践产生了影响。优先考虑缩短住院时间的文化导致康复导向型护理减少。更关注危机和风险管理的卫生专业人员减少了消费者参与护理计划的机会。
